New patient office visit (30-44 min)
Facility: Graham County Hospital
Billing Code: 99203 (CPT)
- CPT Billing Code: 99203
- Insurance Median: $99
- Cash Discount Price: $118
- vs. Medicare Baseline: 0.84x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $117.57 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Medicare (plans) | $88 | 75% |
| UnitedHealthcare | $94 - $112 | 80% |
| Celtic Commercial-All Other Plans | $97 | 83% |
| Blue Cross Blue Shield | $100 | 85% |
| Wppa (Providers Care)-All Plans | $112 | 95% |
Consumer Guidance & Cost Commentary
For this new patient office visit (30-44 minutes) at Graham County Hospital in Hill City, KS, the cash price is $118.00, which matches the median amount paid by patients. This cash rate is significantly lower than the negotiated rates charged by major payers such as UnitedHealthcare ($94–$112) and Wppa ($112), as well as the Medicare benchmark of $117.57. Because commercial insurance contracts often include administrative overhead and multi-layered pricing structures, the negotiated rates can exceed the cash price, making self-pay a potentially more affordable option for patients with high deductibles or those without immediate insurance coverage.
To minimize unexpected costs, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can lower the final bill by 20% to 50%. If you do use insurance, be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, though it is important to verify network status and avoid signing out-of-network consent waivers for mandatory ancillary services. Since over 80% of hospital bills contain errors, always request a detailed, itemized CPT-coded statement rather than accepting a summary bill, and dispute any discrepancies in writing to ensure you are only paying for services actually rendered.